Medicare Benefits Schedule - Item 32106

Anterolateral intraperitoneal rectal tumour, per anal excision of, using rectoscopy digital viewing system and pneumorectum, if:
(a) clinically appropriate; and
(b) removal requires dissection within the peritoneal cavity;
excluding use of a colonoscope as the operating platform and not being a service associated with a service to which item 32024, 32025 or 32232 applies 

Multiple Operation Rule

(Anaes.) (Assist.)

Fee: $1,502.00 Benefit: 75% = $1,126.50 85% = $1,403.30

(See para TN.8.17, TN.8.31 of explanatory notes to this Category)

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The following are guidelines for appropriate minimum standards for the performance of GI endoscopy in relation to (a) cleaning, disinfection and sterilisation procedures, and (b) anaesthetic and resuscitation equipment.

 These guidelines are based on the advice of the Gastroenterological Society of Australia, the Sections of HPB and Upper GI and of Colon and Rectal Surgery of the Royal Australasian College of Surgeons, and the Colorectal Surgical Society of Australia.

 Cleaning, disinfection and sterilisation procedures
Endoscopic procedures should be performed in facilities where endoscope and accessory reprocessing protocols follow procedures outlined in:

1. Infection Control in Endoscopy, Gastroenterological Society of Australia and Gastroenterological Nurses College of Australia , 2011;
2. Australian Guidelines for the Prevention and Control of Infection in Healthcare (NHMRC, 2010);
3. Australian Standard AS 4187 2014 (and Amendments), Standards Association of Australia. 

Anaesthetic and resuscitation equipment
Where the patient is anaesthetised, anaesthetic equipment, administration and monitoring, and post-operative and resuscitation facilities should conform to the standards outlined in 'Guidelines on Sedation and/or Analgesia for Diagnostic and Interventional Medical, Dental or Surgical Procedures' (PS09), Australian & New Zealand College of Anaesthetists, Gastroenterological Society of Australia and Royal Australasian College of Surgeons.

Conjoint Committee

For the purposes of Item 32023, the procedure is to be performed by a colorectal surgeon or gastroenterologist with endoscopic training who is recognised by the Conjoint Committee for the Recognition of Training in Gastrointestinal Endoscopy.

Related Items: 30473 30475 30478 30479 30481 30484 30485 30490 30491 30494 30680 30682 30684 30686 30687 30688 30690 30692 30694 32023 32084 32087 32094 32095 32106 32222 32223 32224 32225 32226 32227 32228 32229 32232

Surgeons performing these procedures should be colorectal surgeons and have undergone appropriate training which is recognised by the Colorectal Surgical Society of Australasia. 

Items 32232 and 32106 cannot be claimed in conjunction with each other or with anterior resection items 32024 or 32025 for the same patient, on the same day, by any practitioner.

Related Items: 32106 32232